Evans: Crazy choices on mental illness

In the state of Colorado, people with severe bipolar disorder, major depression or schizophrenia are four times more likely to end up in jail than in treatment.

Police officers see more people with mental illness on a day-to-day basis than psychiatrists do.

And the largest "mental institution" in the United States is a wing of the Los Angeles County Jail known as the Twin Towers, where some 1,400 inmates/patients -- the lines are decidedly blurred -- are housed on any given day.

"Our jails and prisons are filling up with people whose only crime is that they got sick," says former Washington Post journalist Pete Earley, whose best-selling book "Crazy: A Father's Search Through America's Mental Health Madness," takes a disturbing look into a broken system. "And that's costing you and your community in ways you don't even know."

Earley plunged into the madness after his son Mike experienced a manic break while in college. Like an estimated 40 percent of Americans with mental illness, Mike didn't think he had a problem. His father and family knew otherwise, but because the law says only people who are an imminent danger to themselves or others deserve the attention of the system, nobody could keep him under care if he didn't consent.

Mike "was so out of control that a nurse called hospital security," Earley writes of one attempt to get his son help. "Maybe now they will medicate him, I thought. But before the security guard arrived, Mike dashed outside, cursing loudly. ...(T)he doctor told my ex-wife that it was not illegal for someone to be mentally ill in Virginia. But it was illegal for him to treat them unless they consented.

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"'Even if he's psychotic?' she asked.

"Mike couldn't be forcibly treated, the doctor elaborated, until he hurt himself or someone else."

Eventually the young man was deemed dangerous, after he broke into a neighbor's home to take a bubble bath.

"As a parent, I knew something was wrong. He (literally) had tinfoil wrapped around his head and said the CIA was reading his thoughts. But that wasn't against the law. Then, when he became 'dangerous,' everyone wanted to punish him for it," says Early, who will speak in Boulder on April 13 as part of the Interfaith Network on Mental Illness' 7th Annual Spring Conference.

For the book, Earley spent time in the psychiatric cellblock at the Miami-Dade County (Fla.) jail and ferreted out why it's so difficult to get help for mentally ill people in America. It starts with a lack of resources. Earley says that the general recommendation is to have 50 "beds" available for people with mental illness for every 100,000 of population. In Denver, he says, there are just 16.

But mental-health funding is nobody's favorite cause. Officials are a lot more comfortable funding cancer research or police or schools than help for "the psychotic screaming out on the street." Yet that winds up costing taxpayers more in the end. A mentally ill person walking the streets, going in and out of jail, costs between $40,000 and $60,000 a year. For half that, Earley says, we can provide housing and treatment to help them get better.

"Political leaders don't have a lot of money to spend, but we can say, 'Look, I can save or cost-avoid you a lot of money. ... It's the right thing to do, morally and financially,'" he says.

Before the 1960s, someone who was hearing voices simply got locked away forever; some were involuntarily lobotomized. President Kennedy signed the Community Mental Health Act in 1963, but it was never adequately funded, Earley says.

In the '70s the federal government threatened to withhold funds from states that didn't shutter their "One Flew Over the Cuckoo's Nest" hospitals and get patients into more humane community treatment. But in 1980 President Ronald Reagan slashed spending on housing and treatment and thousands of patients wound up on the streets. Since then, we have expected police and courts to handle the problem (Boulder County is an outlier that does an excellent job of helping the mentally ill).

"In Alabama, the best thing to do if you want treatment is to get arrested," Earley says. "Why do we expect the criminal-justice system to solve what is a community health problem?"

Chipping away at stigma, making smarter funding choices and recognizing that 40 percent of mentally ill patients have a "dual diagnosis" of substance abuse all are necessary to start changing the madness of our current approach.

Proper treatment works, and Earley's son is living proof. Mike suffered three more acute incidents -- including being tasered by police -- after the book was published in 2007. But he's now stable, taking medication, holding a low-level job and living in an apartment.

"People can, and do, get better," Earley says.

Pete Earley will speak at 7 p.m. April 13 in the Wittemyer Courtroom in the Wolf Law Building on the CU-Boulder campus. The talk is free and open to the public. CU sociology Ph.D. candidate Tracy Devell will lead discussions on Earley's book at 7 p.m. on April 2 and 9 at First Congregational Church, 1128 Pine St. in Boulder. For more information, go to interfaithnetworkonmentalillness.org.

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